This sheet is about having monkeypox in a pregnancy or while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.
What is monkeypox?
Monkeypox is an illness caused by a virus. The virus belongs to a group of viruses called orthopoxviruses.
Symptoms of monkeypox can begin 5 to 21 days after being exposed to the virus, but most people start having symptoms in 7 to 14 days. The first symptoms to appear can be: fever, headache, muscle aches, backache, swollen lymph nodes (“glands”), chills, and exhaustion (being very tired). Within a few days, a skin rash appears on the body, often starting near the genitals or on the face. The rash causes bumps and sores that can be itchy and painful and that gradually turn into scabs that fall off. In most people, the illness lasts 2 to 4 weeks before clearing up on its own. In some people, monkeypox can cause more severe illness and even death. There is no cure for monkeypox, but certain medications (called antivirals) can help manage symptoms. Vaccination is available for certain people at higher risk of getting monkeypox.
How does monkeypox spread?
Monkeypox spreads from person to person through body fluids, including direct contact with the skin sores or scabs of an infected person, from the fluids that come from these sores (such as on clothing or bedding), or through saliva and respiratory droplets (such as kissing or being in close contact with someone with monkeypox when they breathe, talk, cough, or sneeze). The virus can also pass from a person who is pregnant to their developing baby. It is not known at this time if monkeypox can spread through semen or vaginal fluids.
I have monkeypox. Can it make it harder for me to become pregnant?
It is not known if having monkeypox can make it harder to get pregnant.
Does having monkeypox increase the chance for miscarriage?
Miscarriage can occur in any pregnancy. Based on the available information, it is not known if having monkeypox increases the chance for miscarriage. Infection during pregnancy with other viruses related to monkeypox (such as smallpox) has been found to increase the chance of miscarriage.
Does having monkeypox increase the chance of birth defects?
Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Based on the available information, it is not known if having monkeypox increases the chance of birth defects.
Fever is a possible symptom of monkeypox. A high fever in the first trimester can increase the chance of certain birth defects. Acetaminophen is usually recommended to reduce fever in pregnancy. If you have a fever, talk with your healthcare provider about how to treat it during pregnancy. For more information about fever and pregnancy, see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/hyperthermia-pregnancy/.
Would having monkeypox increase the chance of other pregnancy related problems?
Monkeypox infection has not been well-studied in pregnancy. There is one case report of a stillbirth and one case report of a preterm delivery (birth before week 37) after infection with monkeypox during pregnancy. In both of these cases, the babies also had signs of monkeypox infection. Infection during pregnancy with other viruses related to monkeypox (such as smallpox) has been found to increase the chance of stillbirth and preterm delivery. It is not known if monkeypox infection can cause other pregnancy-related problems, such as low birth weight (weighing less than 5 pounds, 8 ounces (2500 grams) at birth).
Can the virus that causes monkeypox pass to the baby during pregnancy or at the time of delivery?
In the two case reports described above, the monkeypox virus passed to the babies during pregnancy and caused symptoms that included skin sores. It is not known how often a monkeypox infection might pass to a baby during pregnancy or at the time of delivery, or how likely it is to cause problems for the baby.
Does having monkeypox in pregnancy affect future behavior or learning for the child?
Studies have not been done to learn if having monkeypox in pregnancy increases the chance for behavior or learning issues.
Breastfeeding while I have monkeypox:
It is not known if the virus that causes monkeypox can pass to a baby through the breast milk, or if having skin sores on or near the nipples or breasts could cause the virus to get into milk that is expressed or pumped. However, the virus can pass to an uninfected infant through close contact with a person who is infected (such as holding the baby to breastfeed). If you have monkeypox, talk with your baby’s healthcare provider about the best way to feed your baby until you recover. Be sure to talk to your healthcare provider about all of your breastfeeding questions.
If a male has monkeypox, can it make it harder to get a partner pregnant or increase the chance of birth defects?
Studies have not been done to see if having monkeypox could affect fertility or increase the chance of birth defects above the background risk. It is not known if monkeypox can spread to a partner through semen. In general, exposures that fathers or sperm donors have are unlikely to increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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OTIS/MotherToBaby recognizes that not all people identify as “men” or “women.” When using the term “mother,” we mean the source of the egg and/or uterus and by “father,” we mean the source of the sperm, regardless of the person’s gender identity.
